…there was also recognition that it would be unwise to forego an infusion of federal dollars into the state economy. Sandoval’s office estimates that the expansion will enroll 78,000 people and bring more than $700 million federal dollars into the state over the first three years.
“That’s a massive leverage of federal dollars,” said Jeff Mohlenkamp, Sandoval’s budget director. “Considering how many federal dollars we are leveraging, the cost (of expansion) is fairly small.”

Not only is the expansion a good deal for states, but it will benefit their states in other important ways…if Arizona were to forego the influx of federal dollars while continuing to expose its hospitals to rising uncompensated care costs, it could be at an economic disadvantage as compared to its neighbors.

Other governors continue to oppose the Medicaid expansion. But the price of forgoing the expansion — through higher rates of uninsurance, a less healthy workforce, and rising uncompensated care costs — could put them at a competitive disadvantage with states that do expand Medicaid.

The Medicaid expansion is one of the most important parts of the Affordable Care Act—it bring more people into the system, giving them access to cost-effective health care instead of relying on expensive emergency care or forgoing care entirely. It’s a big part of achieving the ultimate purpose of the entire law: making sure everyone, regardless of income, can get their basic health needs met. That’s why we’re paying such close attention to which governors are looking out for their state, and which ones are using their most vulnerable residents as props to score political points. (Looking at you, Rick Perry.)